*Purpose: To evaluate the risk factors of De novo Hepatitis B, especially the Hepatitis B serotype of both doners and recipients in pediatric living donor liver transplantation (LDLT). The effectiveness of prophylactic Lamivudine and the subgroups more responsive to Lamivudine are also defined among patients from anti-HBc-positive liver doners

*Methods: We collected the data of 990 pediatric living donor liver transplant recipients from June 2008 to December 2017 in Shanghai Ren ji Hospital. The preoperative(pre-OT) serum test for Hepatitis B antigen and antibody, pre-OT liver function and other characteristics of both doners and recipients were compared.

*Results: 46(4.88%)cases infected De novo Hepatitis B among 942 recipients underwent LDLT, and the mortality was 29(10.47 %) for patients from anti-HBc-positive doners. Two important determinants for De novo Hepatitis B, anti-HBs negativity for recipient(P=0.010) and anti-HBc positivity for doners(P=0.001) were defined. Meanwhile, there were no difference in other clinical features of both recipients and doners (P >0.05). The incidence of De novo Hepatitis B among recipients from HBsAg(-)anti-HBs(-)anti-HBc(+)anti-HBe(-)HBeAg(-) doners or HBsAg(-)anti-HBs(-)anti-HBc(+)HBeAg(-) recipients was 7(33.33%)/4(19.05%), which is higher compared to other serotypes (P=0.000). Among patients from anti-HBc positive doners, prophylactic lamivudine could reduce the morbidity of De novo HBV infection significantly (P=0.000). According to the subgroup analysis, Lamivudine could be used to precisely prevent De novo Hepatitis B in recipients age ≥6 months, graft recipient weight ratio(GRWR) ≥3 and anti-HBc-negative(P<0.05).

*Conclusions: The anti-HBc -positive doners and anti-HBs-negative recipients are at high risk for De novo Hepatitis B. Lamivudine, as prophylactics, has statistical effect among recipients from anti-HBc- positive doners and is especially effective among those recipients age ≥6 months, GRWR≥3 and anti-HBc-negative.

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